Wanda Liddell

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

1128 Roberts St
Muskegon, MI 49442-4133

Phone

(231) 740-7856

NPI assigned

May 22, 2023

Last updated

May 22, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alcohol and Chemical Abuse Consultants Inc

  dba ACAC Inc

  • Addiction (Substance Use Disorder) Counselor
  • Muskegon, MI
  • NPI 1235621251
  NPD (past)
• Alcohol and Chemical Abuse Consultants Inc

  dba ACAC Inc

  • Addiction (Substance Use Disorder) Counselor
  • Muskegon, MI
  • NPI 1447356050
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1477245116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1128 ROBERTS ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494424133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128 ROBERTS ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494424133",
            "telephone_number": "231-740-7856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIDDELL",
        "first_name": "WANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fredric D Levin, DO
• Monique Lewis
• Kamryn Jane Lewkowski, PHARMD
• Ashley Liakos, PHARMD
• Kristine Lynn Lidbeck, FNP-BC
• James A Lieberman, M.D.
• Lifecare of West Michigan Inc
• Lifecircles
• Joseph John Lihan, LLP
• Kim Lilly

• Community Health Worker in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Community Health Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.